Blog Post
Carol Lei, caregiver, discuss with Lena Driscoll, MSN, at UCSF Mission Bay.

16 Workforce Recommendations to Deliver High-Quality Care for People With Serious Illness (Health Affairs)

Date: 
Nov. 15, 2018

Healthforce Center at UCSF Associate Director of Research Joanne Spetz, PhD, co-authored a blog in Health Affairs that includes 16 workforce recommendations for field experts, policy makers and health care leaders, to adopt to better meet the needs of an aging population and those dealing with chronic and serious illness. The recommendations are the result of a May 2018 forum, convened by Healthforce Center, which brought together 40 national leaders from practice, payment, labor, advocacy, and research to accelerate progress toward meeting workforce needs in the next three to five years. 

Top Recommendations to Address Chronic and Serious Illness:

1. Education programs should increase clinical experiences in the care of people with a serious illness during pre-licensure and certification education programs, and health care systems should actively offer such experiences.

2. Congress should ensure funding of relevant programs such as the Geriatrics Workforce Enhancement program.

3. Health care leaders should advocate for payment models that incentivize working in geriatrics, gerontology, palliative care, and team-based care.

Incorporate Family Caregivers Into Health Care Teams

4. Foundations and government funders should commission reviews of the literature on approaches that best support family members in the care of those with a serious illness and prepare clinicians to work with family members as part of the care team.

5. Stakeholder organizations should disseminate the results of such reviews through development, fielding, and evaluation of education curricula for clinicians and family members.

Support The Home Care Workforce

6. Dual Medicare-Medicaid programs should provide incentives and create programs to improve home care worker pay and working conditions.

7. Leading models for home care aide training should be adopted by all state Medicaid programs and regulatory agencies.

8. Researchers should conduct rigorous studies of the impact of higher pay, lower turnover, and better training for home care aides on client outcomes and total health care costs.

Leverage Technology To Advance Patient-Centered Team Care

9. Insurance companies should pressure purchasers of EHRs to demand modules that elicit and record patient goals of care, identify the full care team, and share this information across providers and settings.

10. Health information technology developers should create systems to link EHR data on social determinants of health to social workers and community programs.

11. A learning collaborative similar to the agriculture Cooperative Extension Model should be established to support technology advancement in health care delivery.

Advocate For Payment Models That Support Community-Based Team-Focused Serious Illness Care

12. Medicare Advantage plans should actively offer new services that meet enrollees’ social needs, support clinicians as they develop strategies to link patients to such services, and evaluate how these services impact quality and value of care.

13. CMS should expand the Independence at Home program, as well as other evidence-based programs that better meet the needs of those with a serious illness living at home and incentivize team-based care in geriatrics and gerontology.

Instill Cultural Competency And Humility Skills Across All Health Professions

14. Foundations and government funders should create a national workgroup to define minimum cultural humility and communications competencies and curricula for all health care providers.

15. Licensing and certification boards, and education credentialing boards, should mandate inclusion of the recommended cultural humility and communications competencies in all pre-licensure and certification programs and for continuing education.

Track The Workforce

16. A job analysis should be conducted of emerging care coordination and navigation occupations to improve their definition and ensure inclusion in the Standard Occupational Classification. 

This work was supported by the Gordon and Betty Moore Foundation.

Read the full article in Health Affairs.

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